Balance Skeletal Traction

MANUEL S.
ENVERGA UNIVERSITY FOUNDATION

LUCENA CITY
Granted Autonomous Status
CHED CEB Res. 076-2009
College of Nursing and Allied Health Sciences
Balance Skeletal Traction (BST)

Indications
1. Support
2. Protect and correct deformity
3. Immobilization
4. Reduce pain and muscle spasm
5. Reduce fracture
6. Maintain good body alignment
Equipment
1. Thomas Splint
2. Rest Splint
3. 5 slings of variable
4. 5 paper clips or safety pins
5. Cord Sash
Short – for the thigh
Long – for the traction
Longest – for the suspension
6. Weight bags – suspension and traction. Traction weight is 10% of the body weight,
suspension weight is ½ lighter than the weight of the traction.
7. Braun Bohler
8. Foot Support – to prevent foot drop
Parts of an Orthopedic Bed
1. Firm Mattress
2. Fracture Board
3. Bed Elevator or Shock Block
4. Balkan Frame
a. 4 vertical bars
b. 2 horizontal bars
c. 1 diagonal bar
d. 1 straight bar or cross bar
5. Pulleys – 3
6. Clamps to hold the bars in place
7. Overhead trapeze
APPLICATION OF TRACTION
1. Verify the doctor’s order – discuss the importance of the doctor’s order
To know whether the client is really for BST and which part is to be applies by the
apparatus.
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
LUCENA CITY
2. Inform the patient about the need and purpose of the procedure – to gain cooperation and
reduce anxiety.
3. Preparation:
a. Identify the different parts of orthopedic bed.
b. Assemble the needed equipment: Thomas splint and Pearson attachment
Medial side Lateral side
Medial Upright Upper portion
4. Mount the Thomas and Pearson on the rest splint.
5 Principles in the Application of Slings to be Emphasized:
a. Two longer and wider slings for the thigh portion and the three for the leg area.
b. Smooth and right side of the sling should come in contact with the patient’s skin.
c. It should be not too tight nor too loose.
d. There should be 1-inch distance in between the slings to promote aeration and
ventilation.
e. Popliteal and heal portion should be free from any sling.
How to apply sling?
a. Start from the medial side to the lateral side, secure both ends together. Fan fold nicely on
the lateral aspect and secure with a pin or clip. Observe the principles of not too tight nor
too loose and avoid hitting the patient’s extremity with the pin.
b. The thigh rope should be attached on the medial aspect to the lateral aspect.
5. Insertion of the apparatus under the affected extremity. Three manpower needed:
a. To insert the whole apparatus under the affected extremity.
b. Manual traction to be released after the completion of traction weight on the pulley.
c. To lift the affected extremity:
- Simultaneously at the count of three
- Instruction of the patient:
- Hold on the trapeze, flex the unaffected extremity/leg, at the count of
three, the three manpower to do their work simultaneously.
6. Application of the traction weight:
a. Rope to be attached to the Steinman pin holder to run along the third pulley and
attach the prescribed weight.
b. Check the principles of sling application, and make the necessary.
7. Apply suspension traction:
a. One end of the thigh rope to be attached to the lateral aspect of the ischial ring with a
slip knot
b. Attach the suspension rope in the mid part of the thigh rope, to the first (1st) pulley
insert suspension weight, hang it on the first pulley pass it on the second pulley under
the rest splint clove hitch knot on the thomas splint and another clove hitch knot in
the Pearson, close it with a knot, to secure it.
LUCENA CITY
- Be sure to maintain the traction rope inside, and the suspension weight should be
outside.
8. Remove the rest splint.
9. Apply foot support.
10. Check the principles of Traction. Emphasizing the five (5) Principles of Traction and
discuss the Nursing Care.
- Swing the patient to and from, side to side to check the efficiency of traction.
a. Patient should be on a dorsal recumbent or supine position.
b. Line of pull should be in line with the deformity.
- Positioning of a diagonal bar and positioning of a pulley.
First (1st) pulley should be in line with the thigh, second (2nd) pulley should be in
line with the knee and screw, third (3rd) pulley should be in line with the first (1st)
and second (2nd) pulley.
c. Should always be continuous, emphasize the importance of manual traction.
d. Avoid friction. Rope should be running along the groove of the pulley. Weight should
be hanging freely. Observe for wear and tear of rope and bags.
e. Provide counter traction. Patient’s body weight will serve as counter traction.
COMPLETE REMOVAL OF TRACTION

1. Verify the Doctor’s order – discuss the importance of the doctor’s order.
2. Inform the patient about the need and purpose of procedure.
3. Apply rest splint.
4. Hang suspension weight on the first (1st) pulley.
5. Complete removal of suspension weight. Remove the knot on the Pearson and Thomas.
6. Manual Traction on the Steinman pin holder; remove the traction weight on the third (3rd)
pulley; secure the traction rope on the rest splint; another on the Thomas and Pearson
attachment.
7. Instruct the patient to flex the unaffected leg while holding on the trapeze. Help him
move slowly to the stretcher.
NURSING CARE OF PATIENT’S WITH TRACTION

1. Assessment: assess the patient as to level of understanding and consciousness.
2. Provision of general comfort:
a. Skin Care – head to toe, focus on the sponging of the affected extremity.
HOW TO SPONGE?
1. 2 basins with face towel and soap.
2. Remove sling one by one and sponge.
3. Remove the foot support and sponge.
b. Changing of linen.
c. Provide bedpan as needed. Serve bedpan on the unaffected side, provide pillow at
the back and provide privacy.
LUCENA CITY
d. Perineal Care.
3. Potential Complication with Nursing Interventions:
a. Upper Respiratory – PNEUMONIA – bronchial tapping and deep breathing, change
every 2 hours.
b. Bedsore – good perineal care, increase fluid intake.
c. Urinary and Kidney Problem – good perineal care, provide privacy, offer bedpan, and
increase fluid intake.
d. Bowel Complication – explain procedure, provide privacy, offer bedpan, increase fluid
and fiber intake, propel perineal care.
e. Pin Site Infection – observe for s/sx of infection, loosening pin tract, pus coming out,
foul smelling and fever.
f. Deformity – maintain ROM/PROM, use footboard to avoid foot drop.
4. Provision of Exercises:
a. ROM exercise with the use of trapeze.
b. Deep breathing exercises.
c. Static quadriceps exercises, alternate contractions and relaxation of quadriceps
muscles.
d. Toe pedal exercises.
5. Nutritional Status – depending on the status of patient.
6. Psychological aspect may be due to anxiety, fear of death, fear of the apparatus, fear of losing
job – explain the procedure to the patient and possible outcomes (doctor).
7. Provision of supportive therapy – offer book to read, something to listen, discover interest.
8. Spiritual Aspect – know his religion, encourage relatives to give spiritual care,
communication, and visiting chaplain.
9. Diversional activities to divert attention.

Balance Skeletal Traction

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MANUEL S.

ENVERGA UNIVERSITY FOUNDATION

Balance Skeletal Traction (BST)

COMPLETE REMOVAL OF TRACTION

NURSING CARE OF PATIENT’S WITH TRACTION

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